[Question #10098] Sweat & saliva query

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25 months ago
Dear Dr

I was at an airport in London with my 2 daughters (4 & 6 years old) in a lift with a frantic man about to miss his flight who was visibly sweating. He was African (I only mention this due to HIV-2). 

1) Is there any risk my daughters could catch HIV-1 or HIV-2 from his sweat dripping in their eyes (for example) or from airborne droplets given his heavy breathing and talking?  These fluids could contain small amounts of blood if he had cuts on his lips or skin, I assume.

2) One daughter had been picking her nose (told not to), which may have been sore though it wasn't visibly bleeding at all

Can you please let me know if there is any risk from #1 and if #2 makes any difference?

The circumstances were a bit unusual and I am obviously concerned for my daughters.

Thank you very much for your help. 
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H. Hunter Handsfield, MD
25 months ago
Welcome back to the forum. Thanks for your continued confidence in our services. FYI, I scanned your discussion with Terri with some herpes questions 4+ years ago. I trust those issues are settled.

HIV is not transmitted by either saliva or sweat, and nobody has ever been known to be infected by non-intimate personal contact. In fact, saliva is toxic to HIV; maybe sweat is as well (I'm not aware of research on this aspect). If either sweat or saliva could transmit HIV, there would be thousands if not millions of cases in people whose only exposures were day to day contact with their fellow humans by being served in restaurants, exchanging cash and credit cards, sitting next to sweating persons on a hot bus, etc, etc. But there are almost no HIV infections known among people who did not have the traditional exposures (sex, direct blood contact, etc). The low risk of saliva is also reflected in the absence of proved HIV transmission by kissing and by oral sex. (There have been a few cases in which the oral partner was infected by giving a BJ to an infected male partner, but no others known by oral sex.) And it also is equally obvious that some of the billions of events that involved close contact with other persons' sweat or saliva would have included blood present in those fluids -- but still no known transmissions. Finally, your daughter picking her nose does not increase the risk.

Another way to look at this is that undoubtedly you and your kids have had other contacts with other people that unknowingly included exposure to their sweat or saliva. And for that matter, their blood or sexual fluids. Even blood in the environment isn't a risk:  the household members of people with HIV never catch it themselves, even after years of sharing toilets, kitchens, towels, eating utensil and so on (assuming they aren't also sex partners or share drug injection equipment).  

So I really wouldn't worry about this at all. Let me know if anything isn't clear.

HHH, MD
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25 months ago
Hi Dr Handsfield

Thank you very much for for your swift and clear response - I really appreciate the detail there. 

I can see from your answer that we don't need to differentiate between HIV-1 and HIV-2 in terms of risk for these sorts of events (ie it's the same response for both types of HIV) - please let me know if I've mis-interpreted?

Other than that, no further questions at all from me - thank you. 

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H. Hunter Handsfield, MD
25 months ago
Even in the parts of the world where HIV2 is most common, it's still a lot less frequent than HIV1. 90% of Africa is dominated by HIV1. In any case, even if the person you were near has either virus, there was no risk, for the reasons noted above.---
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25 months ago
Many thanks Dr Handsfield!
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25 months ago
(PS I just have to say and I should have added - it really is an excellent service that you and the team provide. Quite something.)
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H. Hunter Handsfield, MD
25 months ago
Thank you for that nice comment. FYI, the American Sexual Health Association -- the forum sponsor -- is the leading US nonprofit that promotes and advocates for sexual health with a 120-year history of emphasis on STIs. For the past decade this forum has been a significant part of that effort, and Dr. Hook and I are proud to be past ASHA Board members. You might consider supporting ASHA with a tax-deductible donation. There's a Donate link on the home page:  www.ashasexualhealth.org.

Best wishes and stay safe.
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